ROLE OF THE

STROKE NURSE
Andrea Davies RN and Tina Lacy RN
Acute Stroke Services
Christchurch Hospital
◦The overall role of the Stroke RN is to facilitate
and support patients who have had an acute
stroke to receive the right care in the right
place at the right time.
 How the Position Evolved
 The Acute stroke service ran between the two
hospitals following 2011 earthquake.

 ASU was located at PMH but did not have the

capacity to facilitate thrombolysis or acute care

 Following stong leadership and advocacy the

Stroke Nurse role evolved.
◦For both the patient and their families a
stroke usually produces a spectrum of
strong feelings that are essentially a
grieving process. The person with the
stroke grieves the loss of abilities, the
family grieves for the loss of the “person”
they knew.
 Role of the Stroke Nurse
◦Completing initial nursing review of confirmed and
potential stroke patients in AMAU and other
outlying areas

◦Providing ongoing review of outlying stroke

patients as required
 How do we provide early support for the
Patient/Whanau?
◦Explaining what is happening

◦Explaining the therapy pathway

◦Discussing Potential Fatigue

◦Explaining what will happen from here (where they

will go, what tests etc.)
 ◦ Promoting best practice/Acting as a
resource within the wards for patients
with Acute Stroke
◦ Aspirin if no bleed on CT
◦ BP management
◦ BSL monitoring
◦ Temperature monitoring
◦ Oral Hygiene
◦ Mobilisation
◦ Serial ECGs
◦ Etc………
Performing dysphagia screening
◦All stroke patients should be NBM until swallow
screened
◦We can screen all stroke patients who are alert and
don’t have a history of dysphagia
◦We initially assess voice quality and the tongue
◦Followed by cough reflex testing
◦Then observing for overt signs of aspiration
 Initiating / promoting timely referrals to
the MDT within AMAU and other outlying
areas.
 Providing health education to the
patient with stroke / TIA and their family
◦ Type of stroke
/ whanau .
◦ Risk Reduction
◦ Medications
◦ FAST
◦ Driving Restrictions
◦ Fatigue
◦ Stroke Foundation
◦ CSRS/CREST
 Case Study – Mr R
◦ 60 year old
◦ Hx – DVT post surgery 2 years ago (on warfarin for 6 months), anxiety.
◦ Sudden onset of R)leg weakness, R)arm incoordination, R)facial sensation changes
– 1305
◦ Arrival ED 1345
◦ CT 1445
◦ Bolus two hours post stroke
◦ Infusion commenced 1515
◦ Stroke Nurse RN special 12hours
◦ Nil complications
◦ Pt’s symptoms completely resolved. Discharged home, no follow up.
 Role of the Stroke Nurse
◦Facilitating the pathway for patients potentially
requiring thrombolysis.

◦ Administering the Thrombolysis

◦Providing nursing care and monitoring to the

patient post administration

◦Providing reassurance and emotional support to

patients and their families
The aim of treatment after the initial
stage of stroke is rehabilitation – that
is restoring the person with the
stroke to their greatest potential and
maximum independence
 How to contact us
◦We work 7 days a week, 0645-2300
◦ We can be reached through the operator or by
pager 8086
We are more than happy to provide
support, give advice, answer questions etc
so please feel free to contact us
Thank you

Questions?